Her staff’s potential evidently is not reflected in decent pay rises – whilst Ms Totterdell struggles to get by on £175K, her staff have been offered a below inflation 1% rise.

Over-rewarding the already rich is a familiar feature of the Conservative-led Government, who are also intent on seeing the NHS sold off. Administrators and executives getting huge salary hikes is something we may have to get used to. We may also have to get used to a reduction of available procedures as market forces increasingly override medical need.

Public health care should not be seen as either a business opportunity or a means of personal enrichment.

One Response to Rewards for failure – what the increasingly privatised NHS brings

This highlights the fundamental problem with a “blue in tooth and claw” market-forces system.

Pay is determined not by quality and results but by rarity.
Nurses (good/bad/indifferent) are not that relatively rare
NHS senior executives (good/bad/indifferent) are relatively rare

Given that you have to have someone at the top (if only to theoretically carry the can when things go wrong) it is rarity that pumps up the salary.

In some professions there is a conspiracy to maintain that rarity. And this often means that the quality “in the pool” is very variable.

Now if we could find some way to ensure that it is only the really good executives that are rare:
– we might find that there is a sufficient supply of bad and indifferent ones to at least fill vacancies that have to be filled – but fill them at a price commensurate with their (low) rarity.
– there might then be an incentive for the indifferent to try and become good, and for the bad to go elsewhere.